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Hot topic: Competency

MPS medicolegal adviser Dr Jayne Molodynski explains why it is important to recognise the limits of your competence

Competency, in professional terms, is defined as the ability to perform the tasks and roles required to the expected standard. It can be applied to a doctor at any stage in their career, not only to the newly qualified.

Competency encompasses the need to keep up-to-date with changes in clinical practice and the systems that can impact on your role. Continued professional development (CPD) is a pre-requisite of many jobs, but none more so than medicine, which is constantly evolving. Doctors effectively never stop learning; a heavy focus is placed on CPD whatever specialty a doctor may work in.

Recognising your own limitations is the key principle behind competency. The GMC’s Good Medical Practice makes it clear that your duty as a doctor is to recognise and work within the limits of your competence. When providing care, you must work within your own competencies, and ask for advice when you feel out of your depth.

The GMC’s Good Medical Practice makes it clear that your duty as a doctor is to recognise and work within the limits of your competence

This case study illustrates how competency issues can arise in clinical practice:

Mrs J, a dancer in her 40s, visits the emergency department with a sudden thunderclap headache at the back of the head. She is seen by F2 Dr Q. Dr Q organises a CT scan to rule out a subarachnoid haemorrhage, which comes back clear.

His next course of investigation is to test the CSF for xanthochromia. Dr Q begins setting up a tray and equipment to perform a lumbar puncture. A couple of nurses spot that Dr Q is setting up the tray incorrectly, so alert the registrar, Dr A, to what is going on.

Dr A takes Dr Q aside and asks him about what he is planning to do. Dr Q admits that he is unfamiliar with some of the equipment and has only ever read about the procedure. Dr A explains that Dr Q is working beyond his competence, which could have caused Mrs J harm. Dr A uses the opportunity to give Dr Q an impromptu lesson, explaining the procedure as he successfully undertakes a lumbar puncture.

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